Avir at Weatherford

Based on observation, interview, and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety in the facility kitchen reviewed for kitchen sanitation. The facility failed to ensure foods were properly stored, labeled, and dated in the refrigerator and freezer.The facility failed to ensure the floors in the pantry and back hallway were kept clean to avoid buildup of grease, dirt, and dust in the faculty's only pantryThe facility failed to keep the kitchen area maintained in a clean manner to keep the floors, food surfaces, and cooking areas free of debris.The facility failed to ensure the stove was maintained in a clean manner to avoid liquid from seeping from underneath, maintain the drip pans in a safe manner, and keep the back drop free of grease and food splatter.The facility failed to ensure kitchen staff used proper hand washing and sanitation procedures when handling and serving food. The facility failed to ensure kitchen staff did not touch food directly with their hands.The facility…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to inform each Medicaid-eligible resident, in writing, at the time of admission to the nursing facility and when the resident became eligible for Medicaid of the items and services that were included in nursing facility services under the State plan and for which the resident may not be charged, those other items and services that the facility offered and for which the resident may be charged, and the amount of charges for those services, and inform each Medicaid-eligible resident when changes were made to the items and services for 2 of 3 residents (Resident #6 and Resident #32) reviewed for resident rights. The facility failed to ensure Residents #6 and Resident #32 were given a paper copy of the NOMNC (notice of Medicare non coverage) with information on how to appeal the decision when residents were discharged from skilled services at the facility prior to covered days being exhausted.This failure could place residents at risk for not being aware of…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to ensure residents had the right to be free from physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident's medical symptoms for 1 of 8 residents (Resident #3) reviewed for freedom from physical restraints. 1. The facility failed to obtain documentation and/or consent identifying the medical symptoms being treated and an order for a pommel cushion for Resident #3's pommel cushion.2. The facility failed to ensure Resident #3's movement was not restricted, due to a pommel cushion This failure could place residents at risk of unnecessary restriction of their freedom of movement (any change in place or position for the body or any part of the body that the person is physically able to control). Findings include: Record review of Resident #3's electronic face sheet, dated 02/12/2026, revealed a [AGE] year-old male who was admitted to the facility on [DATE] with a reentry admission on…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility must ensure that a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary trach infections for 1 of 24 (Resident #8) residents reviewed for incontinent care. The facility failed to ensure CNA C performed proper peri-care (incontinent care) for Resident #8. This failure could place residents at risk of infections from incontinent care.Findings include: Record review of Resident #8's face sheet, dated 12/04/2025, revealed an [AGE] year-old female who was admitted to the facility on [DATE]. Resident #8 had medical diagnoses which included fracture of the left femur, protein-calorie malnutrition, urinary tract infection, history of falling, anxiety disorder and schizoaffective disorder. Record review of Resident #8's Annual MDS, dated [DATE], revealed in Section C - C0500, a BIMS score of 05, which indicated the resident was severely cognitively impaired. Section H - Bladder and Bowel- revealed for toileting…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to ensure in accordance with State and Federal laws, all drugs and biologicals were stored in locked compartments under proper temperature controls and permitted only authorized personnel to have access to the keys for 1 of 6 medication carts (cart #1) reviewed for medication storage.The facility failed to ensure medication cart #1 was locked and secured while unattended.This failure could place residents at risk of a drug diversion. Findings include:During an observation on 02/10/2026 at 10:55 AM, on south side of the facility, across from the nurses' station, revealed the overflow medication cart (Cart #1) was unlocked and unattended. One male resident in a wheelchair approximately four feet from Cart #1 was observed. The medication cart contained blister packs of blood pressure medications, anti-diabetic medications, diuretics, potassium supplements, anti-platelet medications and blood thinners.During an interview on 02/10/2026 at 11:00 AM, LVN B stated Cart #1 was new and only had overflow medications stored…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure that each resident received food that was palatable, attractive, and at a safe and appetizing temperature for 1 of 1 lunch meal tested for nutritive value, flavor, and appearance: The facility failed to provide palatable food served at an appetizing temperature as evidenced by a sample tray tested on [DATE]. This failure could affect the residents who ate food from the facility's kitchen by placing them at risk of poor food intake and/or dissatisfaction of the meals served. The findings included: During an interview on 11/12/2024 at 10:16 AM, Resident #45 stated the food was not good and was cold. He stated the dietary offered a substitute, but it was not good. During an interview on 11/12/2024 at 10:49 AM, Resident #46 stated the facility had a new cook and nothing tasted good. He stated he was on a mechanical diet being ground up and nothing tasted right. During an observation on 11/12/2024 at 1:10 PM the test tray was on the…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed, in that: The facility failed to ensure open items in the freezer, refrigerator, and dry food storage were dated and labeled and free from expired foods. The facility failed to ensure kitchen staff followed proper hand hygiene during meal preparations. These failures could place residents at risk for food borne illness and cross-contamination. Findings included: During an observation on 11/12/2024 at 9:46 AM of the pantry was; 1 gallon of blended oil, unable to read the received date with no opened date. 1 16 oz. opened clear zip lock bag of marshmallows with no opened date. 1 5 lb. opened bag of potato chips with no opened date. 1 26 oz. opened bag of Dried Classic Mashed Potatoes in a clear zip lock bag with no opened date. 1 8 lb. opened container of Creole Seasoning with no opened date. 1 opened bag of hamburger buns with no opened date. 1 20 oz. opened loaf of bread with…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure residents' drug regimens were free from unnecessary drugs for 2 of 5 residents (Resident #'s 61 and 76) whose records were reviewed for psychotropic drugs, in that: 1. Resident #61 received an order for the antianxiety medication Valium PRN (as needed), and the order did not include an end date after 14 days. Valium was administered on 11/1/24, 11/2/24, 11/3/24, 11/4/24, 11/6/24, 11/8/24, 11/11/24, 11/12/24, 11/13/24, and 11/14/24 PRN. 2. Resident #76 had an order for the antipsychotic medication Seroquel was administered at bedtime11/1/24 thru 11/13/24 for a diagnosis of Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance and anxiety which was not an appropriate indication for use. This failure placed residents at risk for being over medicated or experiencing undesirable side effects and could cause a physical or psychosocial decline in health status. The findings included: Review…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record reviews, the facility failed to establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development of communicable diseases and infections for 3 (Resident #'s 7, 33, and 61) of 4 residents reviewed for infection control , in that: Agency LVN failed to intervene and practice EBP (enhanced barrier precautions) to protect resident's from MDRO'S by not donning a gown when caring for and administering medications to Resident #7 on 11/12/24 via his gastrostomy (an opening into the stomach through the abdominal wall to provide medication and nourishment) tube. The facility failed to intervene and practice EBP when caring for Resident # 33 who had a pressure area on her coccyx. The facility failed to intervene and practice EBP when caring for Resident # 61 a who had a foley catheter . These failures could affect residents and place them at risk for cross contamination and infections. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure residents have the right to formulate an advance directive for 1 of 24 residents (Resident #81) reviewed for advanced directives. The facility failed to have an Advanced Directive, Out of Hospital Do Not Resuscitate (OOHDNR) consent form which include a Representative and physician signature and License # in the electronic charting or admission paperwork for Resident #81. This failure could affect residents by not having their preferences honored concerning advanced directives. Finding included: Record review of Resident #81's electronic face sheet dated [DATE] revealed Resident #81 was an [AGE] year-old female, admitted on [DATE] with DNR status and a diagnosis of Traumatic subdural hemorrhage without loss of consciousness (a collection of blood that takes place due to bleeding creating an enhanced pressure on the brain). Record review of Resident #81's physician's orders dated [DATE] revealed an order for DNR. Resident #81 electronic health…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to ensure that drugs and biologicals used in the facility were secured and stored in accordance with current accepted professional principles for 1 of 1 Treatment Cart observed for medication storage. The facility did not ensure the Treatment Cart was locked and secured on 11/13/24 on 300 hallway with resident present and no nurse present. This failure could place the residents at risk of gaining access to unlocked medications not prescribed to them. Findings included: Observation on 11/13/24 at 11:31 AM revealed the treatment cart was parked in the 300 hallway with a resident within 6 feet of the opened, unsecured cart. No nurse was in sight of the cart. Present in cart were medicated dressings, antiseptic ointment, triple antibiotic ointment, chlorhexidine gluconate solution antiseptic, Iodine swab sticks, adhesive remover, and wound cleanser. In an interview on 11/13/2024 at 11:37 AM the Treatment Nurse stated that she could not see treatment cart because she had walked 3 rooms down and into a resident room to…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchens reviewed. 1. The facility failed to ensure the floors weren't soiled with food particles and grease beneath the appliances and stainless-steel shelf units throughout the kitchen. 2. The facility failed to ensure two of two refrigerators did not have what appeared to be spilled milk, dried liquids, and food crumbs on the bottom shelf. These failures could place residents at risk for foodborne illness and a decline in health status. The findings include: Observations on 09/26/2023 at 9:40 AM, during the initial tour of the facility kitchen, revealed the following: - the floor was soiled with food debris and grease beneath shelves and appliances throughout the kitchen. - 2 of 2 refrigerators had what appeared to be spilled milk, dried liquids, and food crumbs on the bottom shelf. Observations on 09/26/2023 at 9:50 AM revealed daily cleaning logs, dated September 2023, used for all the…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to ensure each resident had the right to a safe, clean, sanitary, comfortable, and homelike environment, including but not limited to receiving treatment and supports for daily living safely on one of six hallways (Hallway 200) and the smoking area for areas reviewed for environment. 1. The facility failed to ensure Hallway 200 did not have a strong odor of urine. 2. The facility failed to ensure the smoking area did not have a foul odor with a large, uncovered bin filled with dirty laundry and a large, uncovered bin filled with trash within the smoking area. These failures could place residents at risk for a diminished quality of life and a diminished clean, homelike environment. The findings include: 1. In an observation during the initial tour on 09/26/23 at 11:24 AM, the entire Hallway 200 had a strong odor of urine. In an observation on 09/27/23 at 9:30 AM, Hallway 200 had a strong odor of urine which became stronger towards the end of…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to ensure assessments accurately reflected the resident's status for 1 of 6 residents (Resident #6) reviewed for accuracy of assessments. The facility failed to ensure Resident #6's MDS accurately reflected the resident hearing loss. This failure could place residents at risk for not receiving care and services to meet their physical needs and promote feelings of well-being and quality of life. The findings include: Record review of Resident #6's, undated, admission Record, revealed a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #6 had diagnoses which included: unspecified hearing loss unspecified ear, speech, and language development delay due to hearing loss, cerebral infarction (stroke), and hemiplegia non dominant side (paralysis on one side of the body). Record review of Resident #6's Annual MDS, dated [DATE], Section B revealed the resident was able to hear adequately. Record review of the resident's care plan…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.